What do Speech/Language Therapists do with children from birth to 3 years of age?
We work with families to provide support to children in the areas of language acquisition, articulation, oral motor stimulation, feeding issues and communication skills. These areas may include improving and working with production of sounds, communication skills development (including sign language), increase in the range of sounds, quality of language use, increase in feeding skills, improved oral motor functioning and development of oral motor muscles to improve language use.

We look at the quality of a child’s speech/language such as their pronunciation and articulation, their ability to communicate their needs, their ability to chew and swallow food properly and their families concerns. Speech Therapists are concerned with helping children reach their full developmental potential and realizing their full range of sounds and communication abilities to improve their quality of life.

Tips for parents from Speech Therapists:
The following is a list of suggestions to facilitate your child’s development.

Children and babies learn through play and interaction with their caregivers, siblings and peers. By nature, they are very repetitive and follow the lead of others around them. They explore their world through touch, sight and sound and learn about the physical properties of all their toys and their own abilities through their intrinsic curiosity and through exploratory play. They develop all of their senses and all of their speech abilities while playing.

Developmental Sequences 1-4 MONTHS:

All babies learn language in stages. They receive information from birth by listening to people talk, make noises and communicate with each other. A baby’s first voice is their cry but they learn to respond in different ways to different pitch levels of voice. If you talk soothingly to a baby, they are more likely to calm than if you talk angrily to them. Before the age of 4 months, it is important to introduce baby to many different sounds and levels of sounds throughout the day.

By the time they are 4 months old, they are beginning to understand the different qualities, pitch and inflections in voices. At this age, they are beginning to use their own voice to practice language through babbling. By spending time with baby, repeating the sounds they are beginning to make, talking to them and singing to them, you are helping them to make connections and develop their own language abilities. Some suggestions to help in this area are:

• Repeat the consonant sounds that baby starts to use
• Give baby words that go along with their consonant sounds (“Ball” for “Bah”, etc.)
• Sing songs and nursery rhymes to baby throughout the day and especially when they are able to attend to you
• Talk to baby throughout the day as you go about your daily activities
• Respond to baby’s cries as this provides feedback to them that they are able to communicate
• Become tuned-in to baby’s cues and respond appropriately
• Use language during routines such as bathing baby, dressing him and feeding him
• Play vocal games with baby using open and closed vowel sounds. Say “Ahh” to the baby and wait for them to respond. Then say “ooo” or “eee” and wait for them to respond again. These back and forth games teach baby pragmatic and semantic rules of language.
• Make funny noises

Developmental Sequences 4-7 MONTHS:

Baby will begin to take a more active role in their speech development after the fourth month. They will begin to use sounds to vocalize attitudes other than crying, namely joy or displeasure. She might begin to respond to her own name when spoken and may begin to play with sounds as a result of realizing she can make funny noises. The single consonants learned in the first 5 months may become chains (bababababa…) and she may use certain sounds to refer to certain things or people (mama or dada). Some suggestions to help with this development are:

• Play Peek-a-boo with baby while dressing him
• Ask baby questions and wait for their response
• Use baby’s name when referring to him or talking to him
• Sing to baby or play music to them
• Babble along with baby
• Use varying intonations and inflections because baby picks these up sooner than words
• Name objects for baby using clear language
• Respond to baby’s sounds and attempts at sounds in a positive way
• Give baby opportunities to use their language with other people or babies.

*A lack of language use or response to language could signify a hearing delay or problem. If you are concerned, talk with your primary care physician.

Birth to 2 months:
-Does not cry when hungry or uncomfortable
-Does not make comfort sounds or sucking sounds
-Cry does not vary in pitch, length and volume to indicate different needs
-Difficulty establishing/maintaining a rhythmical suck/swallow pattern
-Significant loss of breast milk/formula out of side of mouth during feeding

3-5 Months:
-Vocalizes separately from body movements (sound is not a response to body movement)
-Inability to establish or maintain face to face communication during feeding
-Does not vocalize in response to sound stimulation
-Has not begun to laugh by 5 months in response to play
-Difficulty with feedings such as above

5-7 Months:
-Does not babble during play or in response to stimulation (may suggest a hearing problem)
-Does not use voice to vocalize attitudes other than crying
-Does not respond to sound stimulation (indicative of hearing problem)
-Difficulty with swallowing early solids or other feeding issues

7-9 Months:
-Does not look toward sounds or own name
-Is not babbling double consonants (bababa…)
-Difficulty with textures in foods (gagging, chocking, etc.)
-Is unable to participate in conversations with adults using babbling noises
-Does not say “mama” or “dada” nonspecifically
-Does not use different inflections to produce exclamations

9-12 Months:
-Is unable to successfully eat early finger foods or munch/bite on foods
-Cannot babble single consonants such as “ba” or “da”
-Does not respond to words/language appropriately
-Does not experiment with language when playing independently
-Does not participate in conversations by responding with vocalizations

12-15 Months:
-Does not use inflection during vocalization
-Is not experimenting with language during play
-Is not using 1-3 words spontaneously while repeating additional words
-Does not vocalize or gesture to communicate needs
-Is not using “no” emphatically and meaningfully
-Is not using exclamatory expressions such as “Oh-oh”, “No-no”, “Ta-da”, etc.

15-18 Months:
-Is not attempting to sing songs
-Cannot use 10-15 words spontaneously
-Is not using vocalization in conjunction with gestures
-Does not use language to communicate needs
-Is not repeating sounds or words or imitating environmental sounds
-Is not jabbering tunefully during play
-Continues to demonstrate eating problems (swallowing issues, choking, etc.)

18-24 Months:
-Is not using jargon with good inflection
-Cannot label 2-4 pictures while looking at a book
-Is not putting 2-4 words together to form short sentences or communicate needs
-Does not understand nouns, verbs and modifiers and their uses
-Is not using intelligible words to communicate needs
-Cannot imitate 2-4 word phrases
-Does not relay experiences using jargon, words and/or gestures

24-33 Months:
-Cannot sing phrases of songs
-Is not using three word sentences
-Is not using a wide range of consonant and vowel sounds
-Does not use past tense words (“He runned”)
-Is not expressing frustration at not being understood
-Does not use up to or more than 50 expressive words
-Is not imitating phrases or experimenting with new words

33-36 Months:
-Is not responding to questions when asked things
-Is not producing correct beginning sounds of words
-Is having a hard time understanding prepositions
-Is not speaking in complete sentences
-Does not use plurals to refer to more than one (even if not correct)
-Is not participating in storytelling
-Does not have expressive vocabulary of 200-1000 words
-Is not using expressive vocabulary to communicate all needs
-Is not using sentences to communicate

Developmental Sequences 7-12 MONTHS:

Between 7 and 12 months of age, baby will begin to use expressive language as a tool to communicate, even more so than crying. Baby will experiment with inflection and using language to gain attention from parents. Baby may begin babbling with inflection similar to adult speech and they may seem very emphatic at times, as though they were having an actual conversation. He may begin to show understanding of what is being said to him and respond appropriately to requests or questions. He may even begin to respond to voices in a conversational manner. He may begin to respond to the reactions he gets from the sounds he makes or the things he does. During this age range, solid food is generally introduced. Problems in the area of swallowing/eating should be discussed with baby’s doctor and/or a Speech and Language Pathologist. Some ideas to help with his development during this crucial developmental phase are:

• Use inflection appropriately when speaking to baby
• Express excitement and happiness when communicating with baby
• Give baby easy words to use such as “uh-oh”, “oops”, “ta-da”, etc. and respond with excitement when they use it during play
• Give baby names for things she is asking for or things that relate to her
• Provide many opportunities for baby to demonstrate their knowledge by asking them questions such as “Where is daddy?”, “Come here”, “Can I have a kiss?”, etc.
• Talk baby through activities such as dressing, bathing, reading, etc.
• Respond to baby’s actions with surprise, delight or sadness
• Encourage independent play and don’t interrupt if baby is babbling happily to himself

Developmental Sequences 12-18 MONTHS:

There may be a delay in further speech development as baby learns to walk between 1 and 2 years of age. They may concentrate their energy on learning to become mobile and may not be able to work on two activities at once. When baby does use his language, it may be inarticulate. Baby may omit first or last consonant sounds in words or use sounds that do not necessarily replicate the correct sounds of the word. Articulation requires maturation and practice so it will come with time. As baby experiments with language, she may have conversations with people or inanimate objects with good inflection, rhythm and rate. She may begin to use single words or multiple words placed together to form short phrases or sentences. In addition to using exclamatory expressions, baby may begin to sing along to music and use language to greet people. To get his needs met, he may use gestures, sounds or words to communicate and will start understanding more of what is being said to him.

During this developmental sequence, the following suggestions may be used in conjunction with the previous suggestions to help stimulate language development in the toddler:

• Give baby words to go with her gestures when asking for something.
• Do not correct baby directly for their mispronunciations and inarticulateness. Instead, model appropriate use of language indirectly.
• Do not pronounce the word the way the child does. Baby thinks he is saying it correctly and may be confused if you mispronounce it.
• Play with different inflections while talking to baby.
• Interpret baby’s utterances for her and give her words.
• Avoid asking for a response directly (“What’s this?”) and instead, describe the object and try to elicit a response naturally.
• Use appropriate greeting words when leaving or coming as a model for baby (“Hi!”, “Hello”, “Bye-bye”).
• Give baby opportunities to sing and dance to music.
• Do not anticipate baby’s needs. Give baby the desire to communicate her needs.
• Describe and name the object baby is pointing to or gesturing to.

Developmental Sequences 18-24 MONTHS:

At this age, baby understands the value of language and may be using 15-20 words, combining them to create short phrases, communicating his needs through language and playing with language by imitating and repeating words/phrases. During play, baby may be using jargon with inflection to mimic conversations or may jabber tunefully when playing by herself. Baby will understand what is being said to her and may be able to identify or name 2-10 pictures from a book, photo album, magazine or catalog. He may tell his experiences using jargon with real words interspersed and may be able to use 2-4 word phrases such as “Where’s kitty?”, “Want more milk”, “All done”, “No more”, etc. He will be able to be understood approximately 50-65% of the time.

As baby begins to use language as a tool for communication as well as to relate their experiences, some ideas to assist them in this venture are as follows:

• Provide a myriad of models in language use by using many words, phrases, intonations, songs, etc.
• Expand baby’s vocabulary by adding words to their expressions. For example, when they say “kitty”, you would say “Soft kitty”.
• Look at pictures everywhere in the environment and point them out while labeling them. Enjoy reading books with baby and label objects, animals, people in the books.
• Do not expect perfect articulations. Praise all attempts to imitate.
• Expose baby to simple songs and nursery rhymes with easy refrains.
• Model use of 2-4 word phrases throughout your day.
• Listen carefully to what baby is saying and respond by imitating the words and phrases he uses.
• Use questions to help baby expand on their thoughts.

Developmental Sequence 24-36 MONTHS:

Between the ages of 24 months and 36 months, baby will begin vocalizing for all his needs, use longer and longer sentences, begin using pronouns (you, mine, me, etc), use past tense phrases and words, use size words, participating in storytelling, etc. He may have an expressive vocabulary of 200 or more words and be able to say many sentences to describe his experiences or ask for things he needs. By the time baby is 3 years old, her vocabulary has increased to over 1000 words and she is able to manipulate and use those words to get her needs met, to express her desires, to negate things, to ask questions and to describe her experiences.

Some suggestions to help baby to develop and use their language in the context of their every day lives are:

• Be patient and provide time and opportunity for child to use their language
• Expand on baby’s vocabulary by using descriptive words
• Read books to your child and provide books for your child to read independently
• Point things out to your child when you are shopping or traveling
• Laugh together making funny noises
• Practice mouth exercises to improve oral motor muscles and articulation
• Place emphasis on either beginning or ending sounds of words to improve pronunciation
• Sing songs and tell nursery rhymes to promote language development
• Participate in conversations with your child and express interest in their ideas
• Ask question that require a choice and short answer questions
• Use pronouns descriptively (“My blue ball”), and prepositions in your language (“The ball is on the table”, “The ball is under the table”, etc.)
• Allow your child to participate in storytelling sessions